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Zepbound ® (tirzepatide) injection
2.5 mg/ 5 mg/ 7.5 mg/ 10 mg/ 12.5 mg/ 15 mg
This information is provided in response to your request. Resources may contain information about doses, uses, formulations and populations different from product labeling. See Prescribing Information above, if applicable.
What syringe and needle are recommended for use with the Zepbound® (tirzepatide) vial?
Subcutaneous injection of the 0.5 mL dose of tirzepatide may be performed using a 1.0 mL syringe with needle gauge between 29 and 33, and needle length up to 12.7 mm. Shorter syringe needles (eg, 6 mm) are safer and can be used in all adult patients.
See important safety information, including boxed warning, in the attached prescribing information.
Syringe and Needle Recommendations for Use With Tirzepatide Vial
Tirzepatide is a once-weekly injection for subcutaneous (SC) use. It is supplied in a single-dose vial.1
The tirzepatide vial does not contain a preservative.1
Throw away all opened vials after use, even if there is medicine left in the vial.2
The instructions for use for the tirzepatide vial do not contain specific recommendations for
- syringe type
- needle length, and
- needle gauge.2
Health care providers may recommend a specific syringe type and needle suitable for SC injection that they deem appropriate for their patients.
General recommendations are provided below for your reference.
Syringe Type
The total volume of the tirzepatide solution to be injected is 0.5 mL regardless of the dosing strength.1
Syringes of 1.0 mL capacity are recommended to
- allow for the plunger to withdraw past the 0.5 mL dosage marking
- collect and remove any air bubbles in the solution, and
- push the plunger to the final 0.5 mL dosage.2
Healthcare providers may recommend a syringe with a pre-attached needle.2
Syringes with permanently attached needles may offer better dose accuracy and reduced dead space.3
Use of Insulin Syringe
The instructions for use stipulate using 1 syringe and 1 needle as recommended by the health care provider, and therefore, do not preclude the use of an insulin syringe for administration of tirzepatide from a vial.4
The volume of the tirzepatide dose is 0.5 mL. If using a 1 mL insulin syringe designed for U-100 insulin (100 units/mL), the 50 unit mark on the U-100 syringe would be equivalent to 0.5 mL.4,5
There are other insulin syringes, such as U-40, U-80, and U-500, still available in certain parts of the world.5 The conversion for the tirzepatide dose in these syringes would differ. For this reason, health care providers should validate the type of syringe to be used by patients and educate accordingly.
Needle Length
Tirzepatide supplied in a vial should be administered with needles suitable for SC injection.4 These needles typically range from a length of 6 mm to 12.7 mm when used with a syringe (15/64 inch to 1/2 inch).6 A minimum needle length of 2.10 mm is required to puncture the tirzepatide vial stopper.4
Pending availability of needle length, shorter needles are safer and generally better tolerated. Needles of 6 mm in length are currently the safest available syringe needle and can be used in all adult patients, including those with obesity.3,7
Considerations for needle length and injection techniques based on established recommendations for insulin injection are discussed in Considerations for Needle Length and Injection Techniques in Adult Patients.
Length |
Considerations |
6 mm |
May be injected at a 90o angle, ie, perpendicular to the skin surface |
8 to 12.7 mm |
Patients using needles ≥8 mm should use a lifted skinfold and/or a 45o injection angle to reduce the risk of IM injections |
Abbreviations: BMI = body mass index; IM = intramuscular.
Needle Gauge
Injection Site Considerations
Patients can inject tirzepatide subcutaneously in the
Someone else can inject tirzepatide in the patient's
- abdomen
- thighs, or
- back of the upper arms.2
Rotating injection sites for each dose can help to reduce the risk of developing lipodystrophy (pits in skin or thickened skin) and localized cutaneous amyloidosis (skin with lumps) at the injection sites.2
Tirzepatide should not be injected where the skin has pits, is thickened, or has lumps.2
Lipohypertrophy has been linked to the use of both pen and syringe devices and is associated with the failure to rotate injection sites, using small injecting zones, repeatedly injecting in the same location, and reusing needles.3
The pharmacokinetics of tirzepatide injected into sites of lipohypertrophy or amyloid deposits is unknown.
Additional Information From the Tirzepatide Single-Dose Pen
The single-dose pen approved for SC administration of tirzepatide utilizes a 12.7 mm (1/2 inch) and 29 gauge (thin wall) permanently built-in needle (staked needle). This needle is set to inject at a depth of approximately 5.5 mm (1/4 inch).4
Enclosed Prescribing Information
References
The published references below are available by contacting 1-800-LillyRx (1-800-545-5979).
1Zepbound [package insert]. Indianapolis, IN: Eli Lilly and Company; 2024.
2Zepbound Single-Dose Vial [instructions for use]. Indianapolis, IN: Eli Lilly and Company; 2024.
3Frid A, Hirsch L, Gaspar R, et al. New injection recommendations for patients with diabetes. Diabetes Metab. 2010;36(suppl 2):S3-S18. https://doi.org/10.1016/S1262-3636(10)70002-1
4Data on file, Eli Lilly and Company and/or one of its subsidiaries.
5American Diabetes Association. Standards of medical care in diabetes—2024. Diabetes Care. 2024;47(suppl 1):S1-S321. https://diabetesjournals.org/care/issue/47/Supplement_1
6Usach I, Martinez R, Festini T, Peris JE. Subcutaneous injection of drugs: literature review of factors influencing pain sensation at the injection site. Adv Ther. 2019;36(11):2986-2996. https://doi.org/10.1007/s12325-019-01101-6
7Frid AH, Kreugel G, Grassi G, et al. New insulin delivery recommendations. Mayo Clin Proc. 2016;91(9):1231-1255. https://doi.org/10.1016/j.mayocp.2016.06.010
Date of Last Review: June 07, 2024